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Zach Reitano

Things Zach Says on Podcasts

Where to Find Them

Zach Reitano has been a guest on RiskReversal Pod (2 times) , Mad Money w/ Jim Cramer , Plain English with Derek Thompson , The Heart of Healthcare | A Digital Health Podcast , Masters of Scale and Invest Like the Best (Patrick O'Shaughnessy) .

Recently: “Zach Reitano - Building Ro and Why Healthcare Should Be 50% of GDP - [Invest Like the Best, EP.500]” on Invest Like the Best (Patrick O'Shaughnessy) (November 2026); “"Healthcare Is a Handmade Luxury Good" | Ro Co-Founder and CEO Zach Reitano” on The Heart of Healthcare | A Digital Health Podcast (June 2024); “Rapid Response: Riding the Ozempic wave, w/RO's CEO Zach Reitano” on Masters of Scale (March 2024); “Funders & Founders with Rick Heitzmann & Zach Reitano + Deirdre Bosa Pods like a Billionaire” on RiskReversal Pod (February 2024); “How Weight-Loss Drugs Could Impact U.S. Healthcare and Food. Plus, the Biggest Problems With GLP1s.” on Plain English with Derek Thompson (December 2023); “Okay, Computer: Ro CEO Zach Reitano on Weight Loss Drugs” on RiskReversal Pod (July 2023).

What They Said

“PBMs, to me, they are like the appendix of the healthcare system. At one point in time, they might have served some purpose, but it was so long ago that people can't remember what the heck it was. And turns out when you remove them from the equation, software can do exactly what they would have done historically…” — Zach Reitano, Invest Like the Best (Patrick O'Shaughnessy)

Asked for an example of healthcare working when the patient is the customer, Zach Reitano points to cash-pay GLP-1s sold directly by drugmakers. His claim is that cutting out pharmacy benefit managers lowers prices while manufacturers still earn more.

Invest Like the Best (Patrick O'Shaughnessy) · 2026-11-11 Permalink → Listen →
Invest Like the Best (Patrick O'Shaughnessy) Around 07:08 into the episode
Zach Reitano

…of our expenses. And we pay through our taxes and we play through suppressed wages with our employer. And so you then look and say, okay, well, where is healthcare working? Where does it feel really good? And it feels really good where it's cash pay, where the patient is the customer. Do you

Patrick O'Shaughnessy

have a favorite example of that?

Zach Reitano

…they go up six, seven, eight percent year over year over year. And so the patent cliff, my hope, and I think you're already starting to see this, more middlemen that do absolutely nothing are getting removed from the process. So they are able to capture the same, if not more, gross profit while prices come down. If you look at Lily's earnings, prices come down, volume far outstrips it. And PBMs, to me, they are like the appendix of the healthcare system. At one point in time, they might have served some purpose, but it was so long ago that people can't remember what the heck it was. And turns out when you remove them from the equation, software can do exactly what they would have done historically. And so you even see with GLP1s, PBM goes away, insurance company largely goes away. People can debate that and whether or not it should and what they should cover. But for cash pay purposes, PBMs and insurance companies go away. Prices go from $1,300 to $149. And the people making the drugs are making more money. And so you can see that where it's working, the patient is in control and ethic.…

Patrick O'Shaughnessy

love to use Roe as just a great example since you know all the data like the back of your hand. Give us a sense of the lineup of products right now and what the pie chart looks like today. What percent are they spending on each of the majority?

Zach Reitano

Yeah, I have to. So we have four main categories. Roe is the leading provider of GLP1s in the country. Cardiometabolic Health is a number one category, then sexual health, dermatology, and fertility. And the fastest growing part of the business is GLP1s. And oftentimes people will say, as this has…

Patrick O'Shaughnessy

So I actually would love to spend a few minutes on each of the four driving leading categories, obviously starting with GLP1s. Why have you been so effective? What has made you the leader? Why don't people just go to these new direct services that the ARMA companies have? What is it about Roe that…

Speaker names come from our own diarization. The position is estimated from where the line sits in the episode.
“If I had to say, what is the problem with our healthcare system? It is that the patient is not the customer… whoever controls the flow of money at the point of purchase, that's the customer. That's the stakeholder that everyone builds around. And patients, individuals, we pay for our healthcare. We just are not the customer in the majority of the interactions.” — Zach Reitano, Invest Like the Best (Patrick O'Shaughnessy)

Asked what he has learned about the healthcare system that people don't appreciate, Ro co-founder Zach Reitano names the one flaw he sees behind most others, and the problem Ro is trying to solve.

Invest Like the Best (Patrick O'Shaughnessy) · 2026-11-11 Permalink → Listen →
Invest Like the Best (Patrick O'Shaughnessy) Around 05:33 into the episode
Zach Reitano

…The majority of the way we die is with a slow clock, right? Chronic disease. And that has massively been rising, as you mentioned, the last 20, 30, 40 years. So those two things are really the makeup of how illness happens in the US and how people die. And then that's how the money gets spent. As

Patrick O'Shaughnessy

you think about the whole thing, what is the most surprising thing that you've come to learn about the system that you think people may not appreciate fully?

Zach Reitano

…you go into the healthcare system, there's a fundamental mismatch of incentives. And if I had to say, what is the problem with our healthcare system? It is that the patient is not the customer. That's the problem that we're trying to solve at Roe. And I think you see it working, but that is the fundamental problem. And the reason being is, I mean, you see this in every business that you talk to, whoever controls the flow of money at the point of purchase, that's the customer. That's the stakeholder that everyone builds around. And patients, individuals, we pay for our healthcare. We just are not the customer in the majority of the interactions. So our out-of-pocket expenses, the minority of our expenses. And we pay through our taxes and we play through suppressed wages with our employer. And so you then look and say, okay, well, where is healthcare working? Where does it feel really good? And it feels really good where it's cash pay, where the patient is the customer. Do you

Patrick O'Shaughnessy

have a favorite example of that?

Zach Reitano

You look at LASIK eye surgery, cost comes down, quality improves, convenience increases. You look at breath augmentation, you look at cosmetic surgeries, costs come down, quality improves, convenience improves. You look at GLP1s, or I take GLP1s, and they are like this beautiful foil for the rest…

Patrick O'Shaughnessy

love to use Roe as just a great example since you know all the data like the back of your hand. Give us a sense of the lineup of products right now and what the pie chart looks like today. What percent are they spending on each of the majority?

Speaker names come from our own diarization. The position is estimated from where the line sits in the episode.

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